Rheumatologists need to match patient’s health literacy, says study

Communication between physicians and patients with systemic lupus erythematosus (SLE) leaves a lot to be desired, with a recent study suggesting that rheumatologists must beef up communication to match the health literacy (HL) of their patients. Doing so may foster trust and improve self-management and outcomes in SLE.

A team of investigators conducted this cross-sectional study using baseline data from the Trust Measurement for Physicians and Patients with SLE (TRUMP2-SLE) study, an ongoing multicentre cohort study being carried out at five academic centres.

The team assessed the three dimensions of HL using the 14-item Functional, Communicative, and Critical Health Literacy Scale. Each item on the scale utilized a 4-point Likert scale. They assessed trust in one’s physician and trust in physicians in general using the 5-item Wake Forest Physician Trust Scale, (0‒100 points) and fitted general linear models.

Overall, 362 patients with SLE participated in the study. Higher functional (per 1-point increase: mean difference [MD], 3.39, 95 percent confidence interval [CI], 0.39‒6.39) and communicative HL (MD, 5.88, 95 percent CI, 2.04‒9.71) improved trust in one’s physician.

On the other hand, higher communicative HL increased trust in physicians in general (per 1-point increase: MD, 7.09, 95 percent CI, 2.34‒11.83), but higher critical HL reduced this trust (MD, ‒6.88, 95 percent CI, ‒11.72 to ‒2.04). Additionally, longer internet use correlated with both higher communicative and critical HL.

“[The findings] suggest that the formation of the rheumatologist-patient relationship may negate the effect of high critical HL in building trust,” according to the investigators, noting that patients who trust their physicians demonstrate good medication adherence, self-management, and favourable disease outcomes.